Rome III Functional Constipation and Irritable Bowel Syndrome With Constipation Are Similar Disorders Within a Spectrum of Sensitization, Regulated by Serotonin
Background & Aims Patients with irritable bowel syndrome with constipation (IBS-C) and patients with functional constipation (FC) have similar symptoms, and these disorders overlap in their diagnostic features. Little is known about their overlap in physiology or the involvement of serotonin sig...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 2013-10, Vol.145 (4), p.749-757 |
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| container_title | Gastroenterology (New York, N.Y. 1943) |
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| creator | Shekhar, Chander Monaghan, Phillip J Morris, Julie Issa, Basma Whorwell, Peter J Keevil, Brian Houghton, Lesley A |
| description | Background & Aims Patients with irritable bowel syndrome with constipation (IBS-C) and patients with functional constipation (FC) have similar symptoms, and these disorders overlap in their diagnostic features. Little is known about their overlap in physiology or the involvement of serotonin signaling. We investigated relationships between platelet-depleted plasma concentrations of serotonin, gastrointestinal symptoms, and motor−sensory function in patients with FC or IBS-C compared with healthy volunteers (controls). Methods We measured platelet-depleted plasma concentrations of serotonin in fasting and fed individuals with IBS-C (n = 23; 19−50 years old), FC (n = 11; 25−46 years old), and controls (n = 23; 20−49 years old) recruited in Manchester, UK. We also quantified abdominal and bowel-related symptoms, rectal sensitivity, oro-cecal transit, and colonic (whole intestine) transit. Results Patients with IBS-C or FC had similar baseline symptoms, bowel habits, oro-cecal and colonic transit, and fasting concentrations of serotonin and response to meal ingestion. Only patients with IBS-C had increased symptoms after ingestion of a meal ( P |
| doi_str_mv | 10.1053/j.gastro.2013.07.014 |
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Little is known about their overlap in physiology or the involvement of serotonin signaling. We investigated relationships between platelet-depleted plasma concentrations of serotonin, gastrointestinal symptoms, and motor−sensory function in patients with FC or IBS-C compared with healthy volunteers (controls). Methods We measured platelet-depleted plasma concentrations of serotonin in fasting and fed individuals with IBS-C (n = 23; 19−50 years old), FC (n = 11; 25−46 years old), and controls (n = 23; 20−49 years old) recruited in Manchester, UK. We also quantified abdominal and bowel-related symptoms, rectal sensitivity, oro-cecal transit, and colonic (whole intestine) transit. Results Patients with IBS-C or FC had similar baseline symptoms, bowel habits, oro-cecal and colonic transit, and fasting concentrations of serotonin and response to meal ingestion. Only patients with IBS-C had increased symptoms after ingestion of a meal ( P < .001)—these patients tended to have lower sensory thresholds than patients with FC. Defecation frequency in the combined group of patients with IBS-C or FC correlated inversely with serotonin concentration ( r = −0.4; P = .03). Serotonin concentration also correlated with pain threshold ( r = 0.4; P = .02) and stool threshold ( r = 0.5; P = .06), which correlated inversely with defecation frequency ( r = −0.3; P = .10). Conclusions FC and IBS-C, based on Rome III criteria, are not distinct disorders, symptomatically or physiologically. Instead, they appear to lie in a spectrum of visceral sensitivity modulated by serotonin signaling. Symptom response to meal ingestion should be considered in patient classification.</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1053/j.gastro.2013.07.014</identifier><identifier>PMID: 23872499</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>5-HT ; 5-Hydroxytryptamine ; Adult ; Constipation - etiology ; Constipation - physiopathology ; Female ; Gastroenterology and Hepatology ; Gastrointestinal Transit ; Humans ; Irritable Bowel Syndrome - etiology ; Irritable Bowel Syndrome - physiopathology ; Middle Aged ; Neurotransmitter ; Sensory Thresholds ; Serotonin - blood ; Serotonin - physiology ; Visceral Sensitivity</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 2013-10, Vol.145 (4), p.749-757</ispartof><rights>AGA Institute</rights><rights>2013 AGA Institute</rights><rights>Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-26801d01854b086e423d8fc9f38bde8fb2446fbe4aacdacf95fd7321dbd2b5fa3</citedby><cites>FETCH-LOGICAL-c463t-26801d01854b086e423d8fc9f38bde8fb2446fbe4aacdacf95fd7321dbd2b5fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0016508513010421$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23872499$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shekhar, Chander</creatorcontrib><creatorcontrib>Monaghan, Phillip J</creatorcontrib><creatorcontrib>Morris, Julie</creatorcontrib><creatorcontrib>Issa, Basma</creatorcontrib><creatorcontrib>Whorwell, Peter J</creatorcontrib><creatorcontrib>Keevil, Brian</creatorcontrib><creatorcontrib>Houghton, Lesley A</creatorcontrib><title>Rome III Functional Constipation and Irritable Bowel Syndrome With Constipation Are Similar Disorders Within a Spectrum of Sensitization, Regulated by Serotonin</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>Background & Aims Patients with irritable bowel syndrome with constipation (IBS-C) and patients with functional constipation (FC) have similar symptoms, and these disorders overlap in their diagnostic features. Little is known about their overlap in physiology or the involvement of serotonin signaling. We investigated relationships between platelet-depleted plasma concentrations of serotonin, gastrointestinal symptoms, and motor−sensory function in patients with FC or IBS-C compared with healthy volunteers (controls). Methods We measured platelet-depleted plasma concentrations of serotonin in fasting and fed individuals with IBS-C (n = 23; 19−50 years old), FC (n = 11; 25−46 years old), and controls (n = 23; 20−49 years old) recruited in Manchester, UK. We also quantified abdominal and bowel-related symptoms, rectal sensitivity, oro-cecal transit, and colonic (whole intestine) transit. Results Patients with IBS-C or FC had similar baseline symptoms, bowel habits, oro-cecal and colonic transit, and fasting concentrations of serotonin and response to meal ingestion. Only patients with IBS-C had increased symptoms after ingestion of a meal ( P < .001)—these patients tended to have lower sensory thresholds than patients with FC. Defecation frequency in the combined group of patients with IBS-C or FC correlated inversely with serotonin concentration ( r = −0.4; P = .03). Serotonin concentration also correlated with pain threshold ( r = 0.4; P = .02) and stool threshold ( r = 0.5; P = .06), which correlated inversely with defecation frequency ( r = −0.3; P = .10). Conclusions FC and IBS-C, based on Rome III criteria, are not distinct disorders, symptomatically or physiologically. Instead, they appear to lie in a spectrum of visceral sensitivity modulated by serotonin signaling. Symptom response to meal ingestion should be considered in patient classification.</description><subject>5-HT</subject><subject>5-Hydroxytryptamine</subject><subject>Adult</subject><subject>Constipation - etiology</subject><subject>Constipation - physiopathology</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Gastrointestinal Transit</subject><subject>Humans</subject><subject>Irritable Bowel Syndrome - etiology</subject><subject>Irritable Bowel Syndrome - physiopathology</subject><subject>Middle Aged</subject><subject>Neurotransmitter</subject><subject>Sensory Thresholds</subject><subject>Serotonin - blood</subject><subject>Serotonin - physiology</subject><subject>Visceral Sensitivity</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks9u1DAQxiMEokvhDRDykQMJ_pdd54JUlhYiVUJqQBwtx54UL4m9tR2q5Wl4VJxuQYILp5Hl7_tGM78piucEVwTX7PWuulYxBV9RTFiFNxUm_EGxIjUVJcaEPixWuazLGov6pHgS4w5j3DBBHhcnlIkN5U2zKn5e-QlQ27boYnY6We_UiLbexWT3anki5QxqQ7BJ9SOgt_4WRtQdnAmL8YtNX_-WnwVAnZ3sqAJ6Z6MPBkK809mchbo96BTmCfkBdeCiTfbHnfEVuoLreVQJDOoP-S_45J11T4tHgxojPLuvp8Xni_NP2w_l5cf37fbsstR8zVJJ1wITg4moeY_FGjhlRgy6GZjoDYihp5yvhx64UtooPTT1YDaMEtMb2teDYqfFy2PuPvibGWKSk40axlE58HOUhLNa8Ca3yVJ-lOrgYwwwyH2wkwoHSbBc2MidPLKRCxuJNzKzybYX9x3mfgLzx_QbRha8OQogz_ndQpBRW3AajA15a9J4-78O_wbo0Tqr1fgNDhB3fg4Zb55FRiqx7Jb7WM6DMEwwp4T9AnEtupU</recordid><startdate>20131001</startdate><enddate>20131001</enddate><creator>Shekhar, Chander</creator><creator>Monaghan, Phillip J</creator><creator>Morris, Julie</creator><creator>Issa, Basma</creator><creator>Whorwell, Peter J</creator><creator>Keevil, Brian</creator><creator>Houghton, Lesley A</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131001</creationdate><title>Rome III Functional Constipation and Irritable Bowel Syndrome With Constipation Are Similar Disorders Within a Spectrum of Sensitization, Regulated by Serotonin</title><author>Shekhar, Chander ; Monaghan, Phillip J ; Morris, Julie ; Issa, Basma ; Whorwell, Peter J ; Keevil, Brian ; Houghton, Lesley A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-26801d01854b086e423d8fc9f38bde8fb2446fbe4aacdacf95fd7321dbd2b5fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>5-HT</topic><topic>5-Hydroxytryptamine</topic><topic>Adult</topic><topic>Constipation - etiology</topic><topic>Constipation - physiopathology</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Gastrointestinal Transit</topic><topic>Humans</topic><topic>Irritable Bowel Syndrome - etiology</topic><topic>Irritable Bowel Syndrome - physiopathology</topic><topic>Middle Aged</topic><topic>Neurotransmitter</topic><topic>Sensory Thresholds</topic><topic>Serotonin - blood</topic><topic>Serotonin - physiology</topic><topic>Visceral Sensitivity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shekhar, Chander</creatorcontrib><creatorcontrib>Monaghan, Phillip J</creatorcontrib><creatorcontrib>Morris, Julie</creatorcontrib><creatorcontrib>Issa, Basma</creatorcontrib><creatorcontrib>Whorwell, Peter J</creatorcontrib><creatorcontrib>Keevil, Brian</creatorcontrib><creatorcontrib>Houghton, Lesley A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shekhar, Chander</au><au>Monaghan, Phillip J</au><au>Morris, Julie</au><au>Issa, Basma</au><au>Whorwell, Peter J</au><au>Keevil, Brian</au><au>Houghton, Lesley A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rome III Functional Constipation and Irritable Bowel Syndrome With Constipation Are Similar Disorders Within a Spectrum of Sensitization, Regulated by Serotonin</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>2013-10-01</date><risdate>2013</risdate><volume>145</volume><issue>4</issue><spage>749</spage><epage>757</epage><pages>749-757</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><abstract>Background & Aims Patients with irritable bowel syndrome with constipation (IBS-C) and patients with functional constipation (FC) have similar symptoms, and these disorders overlap in their diagnostic features. Little is known about their overlap in physiology or the involvement of serotonin signaling. We investigated relationships between platelet-depleted plasma concentrations of serotonin, gastrointestinal symptoms, and motor−sensory function in patients with FC or IBS-C compared with healthy volunteers (controls). Methods We measured platelet-depleted plasma concentrations of serotonin in fasting and fed individuals with IBS-C (n = 23; 19−50 years old), FC (n = 11; 25−46 years old), and controls (n = 23; 20−49 years old) recruited in Manchester, UK. We also quantified abdominal and bowel-related symptoms, rectal sensitivity, oro-cecal transit, and colonic (whole intestine) transit. Results Patients with IBS-C or FC had similar baseline symptoms, bowel habits, oro-cecal and colonic transit, and fasting concentrations of serotonin and response to meal ingestion. Only patients with IBS-C had increased symptoms after ingestion of a meal ( P < .001)—these patients tended to have lower sensory thresholds than patients with FC. Defecation frequency in the combined group of patients with IBS-C or FC correlated inversely with serotonin concentration ( r = −0.4; P = .03). Serotonin concentration also correlated with pain threshold ( r = 0.4; P = .02) and stool threshold ( r = 0.5; P = .06), which correlated inversely with defecation frequency ( r = −0.3; P = .10). Conclusions FC and IBS-C, based on Rome III criteria, are not distinct disorders, symptomatically or physiologically. Instead, they appear to lie in a spectrum of visceral sensitivity modulated by serotonin signaling. Symptom response to meal ingestion should be considered in patient classification.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23872499</pmid><doi>10.1053/j.gastro.2013.07.014</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 5-HT 5-Hydroxytryptamine Adult Constipation - etiology Constipation - physiopathology Female Gastroenterology and Hepatology Gastrointestinal Transit Humans Irritable Bowel Syndrome - etiology Irritable Bowel Syndrome - physiopathology Middle Aged Neurotransmitter Sensory Thresholds Serotonin - blood Serotonin - physiology Visceral Sensitivity |
| title | Rome III Functional Constipation and Irritable Bowel Syndrome With Constipation Are Similar Disorders Within a Spectrum of Sensitization, Regulated by Serotonin |
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